Tribes and Silos in Social Media: Twitter, Blab, Periscope and other Examples

I got truly excited when I found out the topic for this week’s Healthcare Leadership tweetchat: Tribes and silos in healthcare. I’ve written about healthcare silos at length, specifically “workflow silos” on the @HL7Standards blog. I’ve been in silos, back on the family farm in NW Illinois (they are dangerous!). And I’ve talked about mental silos, at length, with Medical Anthropology graduate students (here a couple of amusing stories about those interactions.)

Immediately after this week’s #HCLDR tweetchat, starting at 9:30PM EST, @Jimmie_Vanagon is hosting a Blab on the same topic (tribes and silos in healthcare). To familiarize yourself with Blab video conversation format, I hope you’ll watch a bit of last week’s #HCLDR blab (immediately above) on Coping with Death in Healthcare.

Let’s jump into the questions!

T1 What areas of healthcare are most prone to silos and siloed thinking, & what are the negative aspects of this?

The following areas may not (or may!) be the most important silos in healthcare, but they are the most important silos to ME.

Silos among healthcare and health IT social media, such as tweet chats versus Blabs and Periscopes.

Silos separating thinking in healthcare and health IT from thinking and technology in other industries.

T2 What are best ways to break down silos and better utilize tribes in healthcare?

Frankly? Persistence. Insistence. To overcome resistance. This is exactly my MO re getting folks in healthcare and health IT to take workflow and workflow technology seriously. That, and do your homework, know the subject, have the right credibility, navigate the politics, etc., etc., etc. (as Yul Brenner said).

T3 What healthcare tribe do you belong in, if any? Are you ‘tribal’? Would you like to change that or do you see as a good thing?

Due to education (almost a half dozen degrees) and personal proclivity (verging on dilettantism) I belong to many tribes. However, I’ll focus on a new tribe that I am trying to create: The Workflowistas. Using social media I basically recruit from multiple tribes into a growing tribe of folks who understand healthcare workflow and workflow technology and aim to change healthcare and health IT with that understanding.

T4 How do you see the role for twitter (if any) in breaking down healthcare silos & boundaries and providing bridges between tribes?

Regarding tribalism, Twitter is a two-edged sword. On one hand it makes connecting people in other tribes absurdly easy. On the other hand it also makes it easy for folks with similar mindsets to find each other and ignore the rest of the world. This is Twitter’s fundamental Thesis versus Antithesis. What will be the resulting Synthesis? I think we will see both greater understanding and communication AND insularity and echo (chamber) ing. What an extraordinarily complex, and exciting, system of communications and willful ignorance, such as the world has never seen before!

One strategy I keep trying, over and over, but with only highly uneven success, are various sorts of mashups.

Definition of MASH-UP: something created by combining elements from two or more sources, such as

a piece of music created by digitally overlaying an instrumental track with a vocal track from a different recording

a movie or video having characters or situations from other sources

a Web service or application that integrates data and functionalities from various online sources

Early on, it’s hard to remember, blogs and Twitter were two different tribes. Twitter was an alternative to blog posts. This idea seems ridiculous now, blogging and tweeting so leverage each other. For years I’ve tried to figure how to best merge, leverage, literally combine, my blog posts and Twitter. Tweeting links posts, tweeting links to anchors within posts, embedding tweets in posts, tweeting screen captures of paragraphs within posts, and so on.

I believe the same thing will happen to video streaming, such as with Periscope and Blab. Right now they are seen as competing alternatives. In five years it will be like it is now for blogging and tweeting.

It seems to clear to me that twitter streams and video streams are complementary. I love Twitter. It literally changed my life (for the good, in a big way). But (A), something was missing, though I could not put my finger on exactly what that missing thing was. And (B), I keep hearing rumblings that Twitter is in some sort of trouble. I am always the first to jump to Twitter’s defense, as recently as last week!

RE "Twitter is dying" b/c it's abusive, confusing, unprofitable, or X: maybe. All I can attest to is my personal experience. Seems OK to me.

But here is the problem, even if I ignore (A), even if current Twitter is just fine to me, if there are enough other problems elsewhere, then I worry Twitter might go away or becomes something I don’t like. That’s why I was so pleased to see (C) Twitter buy Periscope ($100M) and (D) most analysts applaud the purchase. I’ve been predicting, and see no reason to change those predictions, that Twitter and Periscope will become an increasingly seamless experience. I even predicted Periscope would add the ability to tweet screenshots a week before it actually happened (I’d seen no rumors).

Twitter doesn’t own Blab, but Blab does a pretty good job of integrating with Twitter. Once can tweet from Blab. One can find the Twitter account for a Blab profile. We’ll likely see more of this, unless Blab seems too much like a competitor to Periscope (in which case we’ll see Blab-like features appearing in Periscope).

I believe I was the first to actually Periscope an entire healthcare tweetchat. On a whim I read and commented on #HCDLR tweets. And believe it or not, a couple dozen folks showed up to watch, listen, and comment! However, if interested in best practices, I wouldn’t watch my Periscope, I’d watch Doc. Nieder’s Periscope (YouTube archive below) during a #HCLDR tweetchat about authentic listening in healthcare. Wow! It confirmed to me that for some topics, I love to have the right person skim and pull out the best golden nuggets, and their own unique perspective: in person, instead of just strings of characters.

Boy was that post prophetic! Some strongly believe Blab and Periscope are disruptive and others just as strongly believe they are complementary. I think this is a good thing. The Next Big Thing seldom arrives without controversy. In fact, being controversial is almost a prerequisite for even being a candidate for The Next Big Thing. Of course, one must also keep in mind, just because something is controversial, doesn’t mean it really is The Next Big Thing.

Ebola & EHR Workflow Engines, Editors & Visibility

Robot-In-My-Pocket

Charles Webster, MD, MSIE, MSIS

Bio: HIMSS14, HIMSS15, and HIMSS16 Social Media Ambassador! If you've got a healthcare workflow story, I want to tell it, blog it, tweet it, interview you, etc.
Chuck Webster, MD, MSIE, MSIS has degrees in Accountancy, Industrial Engineering, Intelligent Systems, and Medicine (from the University of Chicago). He's the ex-CMIO for a three-time HIMSS Davies Award-winning pediatric EHR. Dr. Webster currently services as CMIMO (Chief Medical Informatics Marketing Officer) for workflow technology in healthcare. Chuck also created Mr. RIMP (@MrRIMP) (Robot-In-My-Pocket) a Bluetooth-controlled wearable robot for pediatricians and child life specialists to entertain children. Dr. Webster designed the first undergraduate program in medical informatics, was a software architect in a hospital MIS department, and is a judge for the annual Workflow Management Coalition Awards for Excellence in BPM and Workflow and Awards for Case Management. Chuck is a ceaseless evangelist for process-aware technologies in healthcare, including workflow management systems, Business Process Management, and dynamic and adaptive case management. Dr. Webster tweets from @wareFLO, @HealthITdog, and @MrRIMP (though there is some debate about the last two). He maintains almost a half-a-million words and graphics on numerous websites, including EHR Workflow Management Systems (http://chuckwebster.com), Healthcare Business Process Management (http://HCBPM.com) and the People and Organizations improving Healthcare with Health Information Technology (http://EHRworkflow.com). Please join with Chuck to spread the message: Viva la workflow!